Wide-awake麻醉在手部掌指骨骨折中的应用  

Application of Wide-awake anaesthesia in hand fracture

作　　者：张彦武 宫可同[2] 张波[2] 徐建华[2] ZHANG Yanwu;GONG Ketong;ZHANG Bo(Tianjin University of Chinese Medicine,Tianjin,300202,China)

机构地区：[1]天津中医药大学,天津300202 [2]天津市天津医院手显微一病区,天津330193

出　　处：《实用手外科杂志》2020年第2期139-141,共3页Journal of Practical Hand Surgery

摘　　要：目的探讨Wide-awake麻醉在手部掌、指骨骨折中的应用及临床效果。方法2018年1-10月,95例近节指骨和掌骨骨折病例均在Wide-awake麻醉下行骨折切开复位内固定术。术前、术中和术后24h的疼痛均采用VAS评分法评估,术中评估出血量,术后评估麻醉并发症、术区的血供、骨折愈合情况和手部功能。结果术后随访3~6个月,VAS评分:术前麻醉期2.3分,术中0.4分,术后1.8分;术中出血量平均15 mL;术后无一例出现麻醉并发症,骨折全部愈合,平均愈合时间为2.3个月;手部功能采用TAM评定法评定:优73例,良16例,可6例,优良率93.7%。结论在Wide-awake麻醉下进行手部骨折切开内固定术具有操作简便、出血少、无明显疼痛、安全有效等优点,值得推广。Objective To explore the application and clinical effect of Wide-awake on the treatment of phalangeal and metacarpal fractures.Methods From January to November 2018,95 patients with proximal phalangeal and metacarpal fractures were treated,all patients underwent open reduction and internal fixation under Wide awake anesthesia.Preoperative injection period,intraoperative and postoperative pain within 48 hours were evaluated by VAS score.Blood loss and hand joint flexion and extension were evaluated during operation.Complications of anesthesia,blood supply of operation area,fracture healing and hand function were evaluated after operation.Results Preoperative injection period score 1-3 points,painless operation,postoperative score 0-3,average intraoperative bleeding volume15 mL,intraoperative patients can actively move the joints,no postoperative complications,postoperative bleeding less than 5 ml,The recovery of hand function was assessed by TAM:excellent in 73 cases,good in 16 cases,fair in 6 cases,excellent and good rate was 93.7%.Conclusion Incision and internal fixation of hand fracture under Wide-awake anesthesia has the advantages of simple operation,less bleeding,no obvious pain,safe and effective,and so on.It is worth popularizing.

关 键 词：手部骨折 Wide-awake麻醉 

分 类 号：R614[医药卫生—麻醉学]